Extracorporeal renal replacement modeling system

Abstract

A system, program product and method continuously optimize an ultrafiltration rate during an extracorporeal renal replacement process by modeling physiological and actual rate data. The system maps the sensed, physiological data to a mathematical model to assess the data in terms of the ultrafiltration rate. The model provides parameters used to predict where the treatment is headed based on current conditions. The system processes the parameters in terms of preset criteria to generate the optimized ultrafiltration rate. Where the system is networked, communication of the data may be accomplished using remote and online communication techniques.

Description

FIELD OF THE INVENTION [0001] The present invention generally relates to systems and methods of extracorporeal renal replacement therapy and, more particularly, to control systems and methods for operating a pump in an extracorporeal renal replacement system. BACKGROUND OF THE INVENTION [0002] Several extracorporeal renal replacement procedures, such as dialysis, hemodialysis, hemofiltration, hemodiafiltration, ultrafiltration, and plasmapheresis are used to provide replacement or supplementation of a patient's natural renal function in order to remove fluid and / or waste products from their blood. The specific procedure is tailored to the specific needs of the particular patient. For example, dialysis is used to remove soluble waste and solvent from blood. Hemofiltration is used to remove plasma water and dissolved waste from blood while replacing the removed volume with replacement solution. Hemodiafiltration is used to remove both unwanted solute (soluble waste) and plasma water f...

AI Technical Summary

Benefits of technology

[0013] Ultrafiltration may be accomplished in manner that mitigates the problems of the prior art. The system is proactive in nature, rather then merely reactive, anticipating and correcting potential problems before they occur. Moreover, the system and method of the invention are advantageous because of the multipurpose nature thereof, the repeatability and accuracy of the processes, and the simultaneous, continuous flow of fluids in an extracorporeal blood circuit, while being equally applicable to adult, pediatric and neonatal patients.

[0014] Implementation of either or both of the aforementioned adaptive or supervisory control may increase the autonomy of an extracorporeal renal replacement system. Various advantages follow from the enhanced autonomy. For example, the continuous monitoring and control reduces medical costs and improves the quality of medical care by reducing the need for intermittent supervision of the extracorporeal renal replacement procedure by clinical staff.

Problems solved by technology

In general, current systems for monitoring and controlling renal replacement procedures lack the flexibility and accuracy required to perform such procedures on neonates.

This is mainly due to the absence of a satisfactory automatic control of the pumps employed.

The continuing need to monitor the fluid removed and patient responses lead to a significant increase in nursing care and, thus, increases the cost of the therapy.

Current systems for monitoring and controlling renal replacement procedures lack the ability to autonomously correct these time-dependent flow rate variations with high accuracy, rapid response, and minimal overshoot or transient variations following correction.

The clinical problem observed during hemodialysis is that, during the intrinsic dual treatment processes, replacement of renal function reduces the patient's intravascular or blood volume.

This impacts the heart's ability to pump blood to the tissues and causes many unwanted side effects including, but not limited to, cramping, nausea, vomiting, and diaphoresis.

Such cardiac function compromises can also challenge blood flow to the heart itself and cause arrhythmia or even a heart attack.

While some patients may respond, the effects are not very often consistent and, in particular, patients with intradialytic hypotension (IDH) continue to have problems.

The consequences of IDH may include pain, loss of functional days and death.

The deficiency of this conventional approach is that, if one makes an adjustment based on the hematocrit, the system changes as the fluid removal rate also alters the cardiovascular physiology.

Merely reducing the fluid removal rate may paradoxially induce a state that could worsen the hypotension by interfering with the bodies physiologic response.

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